Читать книгу Hidden Hunger and the Transformation of Food Systems - Группа авторов - Страница 25

It is undisputed that the right course for a person’s health later in life is set during pregnancy, infancy, and early childhood. A healthy lifestyle at this sensitive stage of life has a significantly positive impact on the health of a mother, her child, and the entire family – not just in the short term, but in the medium and long term as well [3, 4]. Unfortunately, the reverse of this also applies. This is vividly illustrated when we look at overweight, for instance, an issue that determines the debate about nutrition in Germany, and is coming into focus in other parts of the world as well.

Obese pregnant women give birth to overweight children more frequently [5–7]. There is a high probability that these children will continue to be obese during their childhood and will carry their excess weight throughout their youth and even into adulthood [1]. Overweight and obesity challenge those affected, but also our society and our entire health and social system as much as other forms of malnutrition. In Germany, 1 in every 5 women of childbearing age is overweight, while 1 in every 7 women is obese [8]. Over 15% of all 3- to 17-year-olds in Germany are overweight or obese (5.9% are obese). At the same time, overweight and obesity are distributed unequally throughout society. Thus, at 27%, the prevalence of obesity in 3- to 17-year-old girls of low socioeconomic status is four times higher than the prevalence among those of high socioeconomic status [9]. Add to that food insecurity in social strata that are threatened or affected by poverty. This often goes along with a one-sided food supply and nutrition that are inadequate in terms of quality, which in turn quickly leads to a chronic undersupply of micronutrients such as vitamins, minerals, and trace elements [10, 11]. Food insecurity is exacerbated as people become confused by the short-lived, contradictory statements they are confronted with. It is thus vital that everyone acquires high levels of competence in matters regarding nutrition and health. People must be able to understand and assess information in order to make informed decisions on that basis.

Accordingly, empowerment is the first leverage point in any strategy to combat malnutrition. A second leverage point for successful preventive and health-promoting measures lies in correctly addressing the parties affected and concerned. It must be taken into account that the target groups we intend to address are precisely those that often accept preventive measures to a lesser extent and make proportionately less use of them [12, 13]. Also, where measures to support a health-promoting diet and sufficient physical exercise are planned and implemented, we must always take into account and use existing state structures.

Using existing structures and avoiding parallel structures represents the third leverage point. In Germany, this means, for instance, that we think in terms of our federated state structure. The fact that the state secretary of the federal state of Baden-Wuerttemberg addressed words of welcome at this congress on the occasion of its opening might show you how much importance we attach to this structure. The federal structure has indeed many advantages in terms of diversity, independence, and personal responsibility. On the other hand, complexity and lack of transparency at times represent a burden to initiatives and offers of prevention and health promotion.

All told, I would say that we have no shortage of good measures. The challenge instead is to ensure that measures work where they are needed, that they complement each other, and that we, given the diversity of opportunities, do not get lost in small details and do not strive to reinvent the wheel at various levels or locations. That is why it is so important to address issues at various existing levels – national, federal, municipality, community – and bring players together through intensive networking.